Off to the doctor

July 6, 2016

One of the hardest things about being a parent is seeing your child scared or in pain and knowing that despite your most fervent wish, you can’t swoop in and take it all away. Casey McPike speaks to GP Dr Nicola Mohan about the best ways to handle doctor’s visits, vaccinations and the like.

Preparation

Bringing a child into an unfamiliar setting like a doctor’s waiting room or hospital ward and expecting them to be okay with whatever happens next, is a tall order. Instead, talk to your child in a calm voice about where you are going, what’s going to happen while they’re there and the fact you’ll be with them. “We all like to know what we’re doing,” says Dr Mohan “and your child is no different. Talking about what you’ll do together afterwards, such as going to the park or having a treat, is a good idea, especially if they’re having a vaccination or minor procedure.”

Be the guinea pig

If your baby or child is hesitant to let the doctor carry out a simple examination, such as a throat or ear check, Dr Mohan suggests offering yourself up as a test case. “I find it helpful to demonstrate whatI’m going to do on a parent or a toy first. Role-playing helps build trust and the child can see for themselves what is going to happen – and the praise they’ll receive afterwards!”

Honesty is the best policy

Whenever possible, be honest with your child about what will and won’t hurt.Dr Mohan says trust is key: “Saying something won’t hurt when it does is very much a one-off tactic and they won’t believe you next time. Give them a heads-up in a calm voice, so they know what to expect, avoiding words or phrases that might alarm them.” If you’ve been honest with them about the sting of a local anaesthetic, then they’ll be more likely to believe you when you tell them the throat swab they need will just tickle and having their chest listened to won’t hurt at all.

Be calm and strong yourself

Babies and children respond to what their parents/caregivers are doing, so if you are panicking then your child probably will, too. Dr Mohan says it’s helpful if parents exhibit a calm and soothing energy “…so we can all focus on comforting the child, not the parent!”

During vaccinations or minor procedures, the nurse or doctor will advise the best way to hold your baby or child. Following their directions is crucial in making sure medical care is administered correctly. Dr Mohan says it’s very difficult to work out how much of a vaccination has been wasted if a child has escaped a too-tentative hold and it could lead to pain for your child if they wriggle out of your grasp while they’re receiving stitches or having something retrieved from their nose, for example.

Distractions

For babies, toddlers and small children, distractions can work wonders. With my first daughter, we blew bubbles to take her mind off anything she didn’t like while seeing the doctor and my second daughter was often plugged into Peppa Pig episodes on my phone. Distractions divert attention from any preparation the doctor or nurse needs to do (for vaccinations, Ministry Of Health guidelines stipulate that they should be drawn up out of sight, with the syringe being covered up as long as possible, which helps with the “out of sight, out of mind” approach). You know best what works to calm or distract your child, so to get through a medical procedure turn to toys, rattles, books, songs, smartphones, bubbles, treats…reach deep into your artillery of distractions and bribes and do whatever works!

Negotiations, but to a point

Anyone who has spent time with a toddler or preschooler can vouch for the fact that kids like to feel they’re in control. In a medical setting, letting your child feel that they’ve negotiated with you can be helpful and can be done as part of your preparation step (for example, agreeing they can have a treat after they’ve had their wound dressing changed). Remind them of your agreement if they’re starting to get anxious but, as Dr Mohan says, “If the child is starting to get distressed, it’s best to only allow a limited period of negotiation before firmly and calmly just getting on with what needs to be done. Extending the negotiation period can lead to increased distress while delaying the inevitable. Sometimes it’s best to just do it, and reward after.”

A spoonful of sugar helps the medicine go down

The fistful of lollies I waved in front of my eldest daughter during her four-year-old vaccinations was purely bribery and corruption, but for babies up to one year old there is actual truth in the old saying. Research shows that a sugar solution given to infants a minute or two before a vaccination reduced their pain. The sugar solution can be made easily with one teaspoon of sugar mixed with two teaspoons of cooled boiled water and administered with an eye dropper or medicine syringe. The sweetness of breast milk has the same effect (with the added bonus that feeding and holding are a comfort for many infants), so feeding prior to, during and after a vaccination is worth a try if your baby is breastfed.

Keeping it topical

For reducing needle-stick pain, there are several topical anaesthetic creams available over the counter at your pharmacy. You’ll need to have a chat with your pharmacist and doctor/nurse first though, as the length of time they take to work varies between products and you’ll want to make sure you’re applying it in the right spot.